Worse than opioids: Alcohol deaths soar among the middle aged, women

Blueneck

Former Staff
Jun 2007
53,872
40,390
Ohio
#11
It's really not that important to argue over which is technically "worse" than the other. We know that each substance is playing a huge role in destroying a lot of lives.

A lot of people in the business of treating addiction will ultimately say we need to dump more money into treatment and counseling, which is always a little bit self-serving seeming, even if it's probably true.
Agreed and it can backfire, VICE has a show about addiction that is shot in a Florida community has seen rehabs become big business, and the result was addicts flocking to the city in the hopes of betting treatment, which wound up creating a great deal of homeless addicts all over the place.

The treatment community needs to do more than just try to help people recover from alcohol use disorders and calling on legislatures to throw more money at them, they need to be at the forefront of attempting to shift cultural attitudes about alcohol. People need to know they're drinking an addictive mild poison and that the mere desire (urge) for a drink is indicative of a problem, regardless of quantity/frequency. Primary care doctors need to be assertively asking their patients about alcohol use and recommending less than 2 drinks a week, and telling their patients that if they compulsively use any more than that, that it's a problem.

There shouldn't need to be this cognitive dissonance and shame around it. It's a very culturally accepted addictive mild poison. There isn't a black-and-white line between "I'm an addict, I'll always be an addict" vs. "I don't have a problem." It can be in the middle of that. People aren't necessarily always a flawed addict or not. Some are mild addicts. Some are moderate addicts. Some people can go from a place of addictive, compulsive, excessive use to basically just not being addicts anymore.
Agreed again. But I think the fact that alcohol is legal in other drugs are not affect whether or not people seek treatment. I would rather see people enter rehab voluntarily as opposed to a option B when they get busted. Alcoholism is treated as medical problem unless you do harm to others, you can go to rehab and come out and go back to your normal life whereas a person who is addicted to illegal drugs often has a record to deal with as well.


There's also a pretty mixed bag of effectiveness of different treatment approaches. 12-step facilitation has shown some good results. Cognitive Behavior Therapy for Alcohol Use Disorders have shown some positive effects. But so have some self-help books. Some rehabs have shown some pretty good results in the short-term, but failed to produce long-term recovery any better than brief outpatient treatment.
I've heard 12 step programs don't have a better success rate than most other types of treatment. I once new a guy who was court ordered to take Antibuse and managed to drink anyway. Some people are just that driven.

The cultural norms around alcohol have it being increasingly ubiquitous and culturally accepted. Major grocery stores have installed growler stations, some grocery stores have bars and drink holders to get people drinking alcohol while shopping, the craft brewery wave of the last 20 years has played a big role. To change this tide is going to take some smart social influencing.
Yes, and I think people who are forced to quit other substances like opiates often wind up as alcoholics due to it's availability. People self medicate when they can't cope. It's kind of natural behavior to my mind. I try to keep my thoughts on other people's addiction problems limited to "how does this affect me?"

Having grown up with alcoholic parents and other family members, they're the worst kind of inebriated you can be. Obnoxious, aggressive and mean and they don't even remember what they did the next day. I would much rather deal with someone on any other kind of drug with the exception of speed.
 
Feb 2011
16,645
5,881
Boise, ID
#14
Agreed and it can backfire, VICE has a show about addiction that is shot in a Florida community has seen rehabs become big business, and the result was addicts flocking to the city in the hopes of betting treatment, which wound up creating a great deal of homeless addicts all over the place.
I'm moderately skeptical of rehab facilities. I realize they help a lot of people get off of alcohol so that they have some hope of arresting their deadly spiral, but some of them also charge (and make) a ton of money without really showing better results than brief outpatient treatment.

Agreed again. But I think the fact that alcohol is legal in other drugs are not affect whether or not people seek treatment. I would rather see people enter rehab voluntarily as opposed to a option B when they get busted. Alcoholism is treated as medical problem unless you do harm to others, you can go to rehab and come out and go back to your normal life whereas a person who is addicted to illegal drugs often has a record to deal with as well.
Voluntary treatment seeking indicates some level of desire to not use the substance anymore, whereas being compelled is more likely to be associated with going through the motions.

I've heard 12 step programs don't have a better success rate than most other types of treatment.
Yeah I think the evidence is just mixed. Twelve-step programs are definitely not worthless, they've helped a lot of people and some really resonate with them for whatever reasons, but they aren't far and away best practice either. Finding a treatment approach that is far and away the best and most effective at treating alcohol use disorders seems to be proving very elusive. It may be that each person needs an individualized approach that takes into account all the other shit going on in their lives, but the problem with that is it's really hard to hold treatment providers accountable to providing the "best, most proven" treatments, when there basically is no such thing as far as we can tell. And that's how providers get away with doing whatever their intuition tells them is best, or much more concerning, whatever is most profitable.

Yes, and I think people who are forced to quit other substances like opiates often wind up as alcoholics due to it's availability. People self medicate when they can't cope. It's kind of natural behavior to my mind. I try to keep my thoughts on other people's addiction problems limited to "how does this affect me?"
My opinion of "people self medicate" is that, meh, maybe, but what I actually think is usually the case is that when people are basically hooked on alcohol, even if only mildly or moderately, their minds will look for whatever rationalization they can come up with. Self-medicating my stress away is just one such rationalization. If that rationalization didn't stick, pivot to "fun." Or maintaining normalcy with friends who drink. Or rewarding themselves for a hard day's work. Or to relax. Or to help fall asleep. Or because it's a beautiful day. Or because the weather is nasty today. People grasp for straws to rationalize to themselves why they're reaching for a drink. In the end, the actual rationalization du jour doesn't matter, it's just a rationalization. The rationalization is one of the biggest perpetuators of alcohol use/one of the biggest barriers to achieving sustained sobriety.
 

Blueneck

Former Staff
Jun 2007
53,872
40,390
Ohio
#15
My opinion of "people self medicate" is that, meh, maybe, but what I actually think is usually the case is that when people are basically hooked on alcohol, even if only mildly or moderately, their minds will look for whatever rationalization they can come up with. Self-medicating my stress away is just one such rationalization. If that rationalization didn't stick, pivot to "fun." Or maintaining normalcy with friends who drink. Or rewarding themselves for a hard day's work. Or to relax. Or to help fall asleep. Or because it's a beautiful day. Or because the weather is nasty today. People grasp for straws to rationalize to themselves why they're reaching for a drink. In the end, the actual rationalization du jour doesn't matter, it's just a rationalization. The rationalization is one of the biggest perpetuators of alcohol use/one of the biggest barriers to achieving sustained sobriety.
Shortly before my mother died, my sister and I had to call the EMT's to take her to the hospital (labored breathing) and even though she was perfectly sober and had been for years, she began almost trying to control the stretcher with body, visibly upset and telling them which way to turn in the hallway, etc. One of them asked us "does she have a history of panic attacks?" And just like that, my sister and I realized she was probably suffering with that her entire life and caused her to drink.

When I was a kid I saw her have a panic attack while attempting to drive on a freeway. She used to sip a drink before she could even go to the grocery store. People made her really nervous and she always acted weird around them, talking non-stop, she was her own one person show.

Anyway, with the right SSRI's she probably would have been fine. I know my childhood would have been a lot calmer.
 

Ian Jeffrey

Council Hall
Mar 2013
74,563
43,298
Vulcan, down the street from Darth Vader
#16
Correct, many people will "self-medicate" with alcohol if they cannot get appropriate medical help and medications, or if they do not understand the real problem in the first place.
 
Jun 2011
49,152
20,599
God Bless Texas
#17
Opiods are legal and people can seek treatment for anything w/o legal consequences. Rehabs don't turn you into the law for admitting to using street heroin or any street drug. Drug addiction is also seen as a disease. Tons of free treatment for it. Well, free to the consumer. It's paid for by the government. There is more care for any kind of addiction than any other mental illness.
 
Likes: johnflesh
Jun 2011
49,152
20,599
God Bless Texas
#18
It's much more gradual in it's medical outcomes, is LEGAL, all of it. Is cultural accepted.

PS When are much more prone to cirrhosis and/or get it earlier than men. (My next neighbor drank herself to death in about 3 years, she was 47)
Opioids are legal. I have two kinds in my cabinet. I could have more if I went and asked for them.
 

johnflesh

Former Staff
Feb 2007
25,537
18,000
Colorado
#20
When Drs. start scripting alcohol, I will see the comparison.
Well it's apples and oranges Sassy. Marketing for a prescribed drug would naturally happen in the waiting room. Marketing alcohol would not make sense in the waiting room.

Neither of those have anything to do with the epidemic though.